Defining the social needs of Tuberculosis patients and the requirement for an outpatient Social Work service in St. James's Hospital

Background/ Aims St. James’s Hospital is the national centre for Tuberculosis (TB) patients. The TB team felt the service would benefit from an outpatient Medical Social Worker(MSW). Funding from Trinity College ‘Med... [ view full abstract ]

Background/ Aims

St. James’s Hospital is the national centre for Tuberculosis (TB) patients. The TB team felt the service would benefit from an outpatient Medical Social Worker(MSW). Funding from Trinity College ‘Med Day’ initiative allowed a MSW to work with the team for 10 months. This study aimed to generate knowledge about social needs of TB patients and how a Social Work role can complement TB care.

Methodology

Action research was used, which uses inquiry and investigation to achieve the goals of the research and evaluate effectiveness. A literature review was carried out. Quantitative data was collected analysing statistics from an audit and outpatients who met with the MSW. Qualitative data was collected using a focus group and direct observations. An outpatient MSW service was trialled for 3 months of the project.

Results

Charts audited 127
Medical card holders 44%
Alcohol 37%
Smoking 29%
Mental health issues 17%
Unemployed 48%
Social welfare recipients 40.2%

MSW service trial:
25 patients were referred to the MSW and support provided related to housing, adjusting to diagnosis, alcohol counselling and social welfare issues. Patients were linked in with several community services. 56% of patients were in receipt of Social Welfare and 44 % lived in rented accommodation.

Qualitative results
Analysis of qualitative data resulted in the emergence of four themes; provision of support, effect of TB on the patient’s life, the role of the family and the role of the professional

Findings
TB patients require practical and emotional supports that can be provided by a MSW service. Social stressors that impact on their lives included stigma, accommodation, substance abuse, financial issues, relationships and isolation. Family were identified as the main support to patients. Adopting a solely medical approach to TB treatment has limitations and the MSW should provide education to the TB team on the MSW role.

Conclusion
TB patients have a need for practical and emotional support that can be provided by a MSW. The MSW should provide the TB team with education on the potential role of a MSW.